High levels of triglycerides can increase your risk of obesity, heart disease, diabetes, and other chronic health conditions. Read on to find out if your levels are in the normal range and what can cause your triglycerides to rise too much.

What Are Triglycerides?

Triglycerides are the scientific term for fats, including the fats you eat in your diet and the fat that is stored in your body. They are formed from a combination of a compound called glycerol and three fatty acids. [1].

Dietary triglycerides are digested and absorbed in the small intestine. They are then packaged together with cholesterol and proteins in particles called chylomicrons, which carry triglycerides from the gut to other tissues. Finally, triglycerdies enter cells to be used as energy [2, 3].

Burning triglycerides for fuel requires a special enzyme (lipoprotein lipase), which is especially important for the muscles [1].

Your liver can also produce triglycerides from sugar and other fats. The created triglycerides can be stored in fat tissue, to be used as needed [2].

For example, your body frees these stored fats into the bloodstream as fatty acids when you don’t eat for a prolonged time. These fatty acids travel back to the liver, which transforms into triglyceride-containing very-low-density lipoproteins (VLDL) that are returned into the blood [4].

On the other hand, your body stores more triglycerides when you eat a lot of unhealthy, saturated fats [5].

Triglycerides are fats you get through diet, store in fat tissue, and burn as fuel when needed. The liver can make triglycerides from sugar and other fats.

Triglycerides Normal Range

A blood test can measure your circulating triglyceride levels. You have to fast overnight before this test to get accurate results, as your triglycerides normally go up one to four hours after meals [6].

Triglyceride levels are classified as follows [3, 7, 8]:

  • Low: Less than 100 mg/dL (1.13 mmol/L)
  • Normal: Less than 150 mg/dL (1.7 mmol/L)
  • Borderline high: 150 to 199 mg/dL (1.7 to 2.3 mmol/L)
  • High: 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
  • Very high:  500 mg/dL or above (5.6 mmol/L)
Triglyceride levels below 150 mg/dL are considered normal.

Causes of High Triglycerides (Hypertriglyceridemia)

About one-third of US adults had high triglyceride levels or hypertriglyceridemia (above 150 mg/dL) from 1999 to 2004. Only about 2% experienced extremely high levels (500 to 2,000 mg/dL), the leading cause of pancreas inflammation in the US [9, 10].

High triglyceride levels can be caused by lifestyle and dietary factors, genetics, and other diseases [11].

On a deeper level, triglycerides will rise too much if [12]:

  • Your liver is producing too much triglyceride-dense VLDL cholesterol
  • Your diet is excessive in unhealthy fats
  • You have low lipoprotein lipase activity, which is the enzyme that breaks down triglycerides

All the potential causes outlined below affect one or more of these conditions.

1) Low-Fat, High-Carhydrate Diets

Low-fat, high-carbohydrate diets are among the most common causes of high triglycerides. But wait–we said that high-fat diet are bad, so doesn’t that mean a low-fat diet should be beneficial? Not quite [13].

Saturated, unhealthy fats are bad. But your body needs healthy fats–such as those found in olive oil and fish oil–to keep your triglyceride levels normal and to maintain your overall health. If you don’t  get enough dietary fats, your body will revert to transforming the sugars you consume into fats [13, 14, 15, 16].

This goes against the popular but unfounded belief that your body won’t store fat as long as you don’t eat fats. In truth, high-carbohydrate diets are much worse than high-fat diets for your triglyceride levels. High-carb, low-fat diets likely also contributed to the obesity epidemic in America over the past few decades [13, 14, 15, 16].

In one study, people with high triglyceride levels and those with normal levels were put either on a regular or on a low-fat, high-carb diet. The results were drastic: the low-fat, high-carb diet increased triglycerides by 60% in both groups! It also reduced the clearence of triglyceride-dense VLDL by almost 40% [13].

Low-fat, high-carbohydrate diets can greatly increase triglyceride levels and contribute to obesity.

2) Obesity

Directly tied to high-carb diets, obesity often leads to high triglyceride levels. People with obesity also often have high “bad” LDL cholesterol and low “good” HDL cholesterol, which burdens blood vessels in the whole body. This combination of factors increases their risk of heart disease, diabetes, inflammation, and other chronic health problems [17].

Obesity often leads to insulin resistance, which is when tissues stop responding to insulin released from the pancreas. As a result, insulin can’t signal tissues to burn fat and glucose can’t enter cells to be used as energy. The liver tries to compensate by storing more fatty acids from dietary sources and producing more VLDL cholesterol, which further worsens the situation [17].

Obseity might turn on lipid-increasing genes. In a meta-analysis of nearly 10,000 Swedish adults, body fat increased the influence of the triglyceride-increasing gene variants, especially in women. In 8,526 Danish adults, those who were obese had higher triglycerides due to genetics, compared to leaner people [18, 19].

Obesity increases the risk of chronic diseases by creating an unfavorable blood fats profile: high triglycerides, high LDL, and low HDL cholesterol.

3) An Underactive Thyroid (Hypothyroidism)

An underactive thyroid (hypothyroidism) increases triglyceride levels by interfering with cholesterol production in the body. As soon as thyroid hormones normalize, triglycerides go back to normal. Even people with mild hypothyroidism and borderline normal thyroid-stimulating hormone (TSH) levels are more likely to have high triglycerides, high LDL, and low HDL [20].

People with an underactive thyroid are more likely to have high triglycerides and LDL, which puts them at an increased risk of heart disease.

4) Vitamin D Deficiency

Vitamin D has many benefits, and supporting normal triglyceride levels is one of them. In a study of 149 Spanish children, those with the lowest vitamin D blood levels (serum 25(OH)D concentrations) had the highest triglycerides [21]

4) Gum Disease

Untreated gum disease (periodontitis) increases blood triglycerides. People with chronic gum inflammation are continually exposed to bacteria, which disrupt immune and lipid balance in the body [22].

5) Smoking

Among 191 women, nonsmokers had 40% lower triglyceride levels than smokers. Smokers also had slightly higher total cholesterol and lower HDL cholesterol. This means that, aside from damaging the lungs and other organs, smoking increases heart disease risk by disrupting blood fats [23].

Vitamin D deficiency, smoking, and gum disease increase triglyceride blood levels.

6) Heavy Drinking

Heavy drinkers have higher triglyceride levels, and they are also at an increased risk of heart disease, alcoholic fatty liver disease, and pancreas inflammation. Excessive drinking increases triglycerides by forcing the liver to release more VLDL, reducing fat-burning, and increasing fat storage in the liver [24].

On the other hand, light to moderate alcohol drinking may lower blood triglycerides [24].

Drinking too much alcohol increases triglycerides and fat storage in the liver.

7) Type 2 Diabetes

In people with type 2 diabetes and metabolic syndrome, tissues stop responding to insulin. Other typical signs are increased belly fat, high triglycerides, low HDL, and high blood pressure. The liver makes large amounts of triglyceride-containing VLDL, while tissues stop burning fats [25]

8) Inflammation & Autoimmunity

In some cases, high triglycerides may be caused by inflammation and infection.

People with chronic inflammatory and autoimmune diseases–such as rheumatoid arthritis, lupus, psoriasis, and infections–often have high triglycerides and low HDL. These disease-triggered lipid changes initially serve to dampen inflammation or fight infection, but they increase the risk of heart disease in the long run [26, 25].

Chronic inflammation and autoimmunity can increase triglycerides and lower HDL, worsening heart health.

9) Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is another cause of high triglyceride levels. Triglycerides can even be used as a marker of the disease, according to one study [27]

10) Kidney Disease

People with chronic kidney disease are already at an increased risk of heart disease. They also often suffer from high triglyceride levels (but normal cholesterol levels), which further increase the risk of heart complications. Triglycerides start to increase eraly on in the disease and reach a maximum in the end stages [28].

Both non-alcoholic fatty liver disease and chronic kidney disease can increase triglyceride levels.

11) Certain Medications

The following medications may increase triglycerides:

  • Synthetic vitamin A used for skin diseases, such as tretinoin (Vesanoid) and adapalene (Differin, Pimpal) [29]
  • Heart medications, including the beta-blockers propranolol (Inderal) and metoprolol (Lopressor) [29]
  • Antipsychotics haloperidol (Haldol) and clozapine (Clozaril) used to treat schizophrenia and bipolar disorder [29]
  • Immunosuppressive drugs cyclosporine (Neoral,) and tacrolimus (Prograf), which reduce the immune response [29]
  • Diuretics hydrochlorothiazide (Apo-hydro) and etozolin (Diulozin) [29]
  • Estrogen replacement therapy and selective estrogen receptor modulators (SERMS) [29]

Additionally, in a study of 773 women with diabetes in pregnancy, blood triglyceride levels were higher in women treated with metformin (type 2 diabetes drug) compared to women treated with insulin [30].

12) Genes

Some genetic variaions may increase the chance of high triglycerides, including [11, 7, 31, 32, 33, 34]:

In 3,474 non-diabetic adults, increased blood triglyceride levels were associated with 39 genetic variants over the course of a 5-year follow-up period [35].

In a 9-year study on over 9,000 Europeans, people with higher triglyceride gene scores had a greater increase in their triglyceride levels compared to those with lower triglyceride gene scores [36].

A case-control study of 569 obese and 194 healthy Chinese children and adolescents revealed that genetic variations in the APOA5 gene (rs662799 and rs651821) may dictate how susceptible a person is to obesity, which is linked with triglyceride buildup [37].

Certain genetic variants have been linked with high triglyceride levels, but more research is needed to determine their relevance.

13) Ethnicity/Race

Men of African origin had lower triglycerides than white men. Additionally, Afro-Caribbean men had significantly lower triglyceride levels compared to either African-American or white men [38].

In 285 overweight adults, women and black participants had lower levels of triglycerides compared to men and white participants [39].

In 5,708 adults, non-Hispanic whites had higher triglyceride levels than non-Hispanic blacks and Mexican-Americans [40].

Men of African origin and women tend to have lower triglyceride levels than non-Hispanic white men.

14) Chylomicronemia Syndrome

Chylomicronemia syndrome is a disorder in which the body does not break down fats correctly. This causes a buildup of blood triglycerides. It occurs due to a deficiency of lipoprotein lipase or apolipoprotein C-II; or, an inhibition of lipoprotein lipase [41, 42].

People with chylomicronemia syndrome have higher triglycerides and they can’t break down fats properly.

15) Personality Traits

Personality traits may play a role in the triglyceride levels. In 5,532 Italians, the ones more impulsive and open to experience had higher triglyceride levels [43].

Impulsivity might raise your triglycerides.

Symptoms

High triglyceride levels do not cause symptoms directly, and individuals will only show symptoms related to the cause of high triglyceride levels, such as hypothyroidism and type 2 diabetes.

Extremely high triglycerides (>400 mg/dL or 4.5 mmol/L) may cause yellowish patches on the skin (xanthomas) [44].

Your symptoms will depend on your underlying disease. High triglycerides don’t usually cause any symptoms.

Health Risks of High Triglycerides

1) Heart Disease

Atherogenic dyslipidemia refers to increased levels of triglycerides and LDL and low HDL–a combination that increases the risk of heart disease, heart attacks, and clogged arteries (atherosclerosis) [45, 46].

High blood triglycerides increase the risk of heart disease even when cholesterol levels are within the normal range. Many studies on diverse populations–healthy men, type 2 diabetes, adults at high risk of borderline-high triglycerides–and over 60,000 people in total have confirmed this [47, 48, 49, 50, 51, 52, 53]

2) Diabetes

Though insulin resistance can increase triglyceride levels, the opposite is also true: increased blood triglycerides can cause insulin resistance [54, 55, 56, 57].

High blood triglycerides increased the risk of type 2 diabetes, independent of other risk factors (obesity, eating habits, smoking, cholesterol, diabetes, and blood pressure) in a 10-year study on 14,000 healthy men [58].

An rise in blood triglyceride by 10 mg/dL increased the risk of type 2 diabetes by 4% in a 12-year study on over 5,000 healthy adults [59].

Interestingly, people who have high triglycerides from specific genetic variants (rs2954029, rs714052, rs7557067, rs17216525, rs10889353, rs7679, rs7819412, rs328, rs3135506, rs662799)  are not at a higher risk of type 2 diabetes [60].

Insulin resistance and high triglycerides fuel each other: one intensifies the other.

3) Nonalcoholic Fatty Liver Disease (NAFLD)

People with nonalcoholic fatty liver disease produce more and remove less triglycerides, due to a high-fat diet or insulin resistance, faulty fatty acid breakdown, or defective VLDL production [4, 1, 61, 62, 63].

In 293 patients, high blood triglycerides predicted developing nonalcoholic fatty liver disease later on [64].

A rise in triglycerides may reveal future nonalcoholic liver disease.

4) Cancer

In studes of over half a million people in total, high blood triglycerides increased the risk of lung, rectal, colon, cervical, ovarian, skin, endometrial, and thyroid cancer, but lowered the risk of prostate cancer and non-Hodgkin’s lymphoma (cancer of the lymphocytes, a type of white blood cell) [65, 65, 66, 66].

However, in a meta-analysis of over million healthy people and cancer patients, increased triglyceride levels were not associated with the risk of prostate or breast cancer [67].

In addition, lower blood triglyceride levels were found in 135 lung cancer patients compared to 39 healthy adults [68].

Some studies suggest that high levels don’t reduce prostate cancer risk, or possibly even increase it [69, 70, 71, 72].

Studies focusing on breast cancer report a positive association between high blood triglycerides and breast cancer risk, whereas one showed an inverse association [73, 74, 75, 76].

Many factors beyong triglyceride levels affect cancer risk and outcomes. More research is needed to tease apart all the influences.

High triglyceride levels may increase the risk of some cancers and lower the risk of others, but the research so far remains unconclusive.

5) Kidney Disease

In 25,641 patients with late-stage chronic kidney disease, high blood triglyceride levels (equal to or above 200 mg/dL) increased the risk of death among patients younger than 65 [77].

Increased blood triglycerides were associated with a viral kidney disease (epidemic nephropathy) in 228 patients [78].

Out of 67 patients with bile acid diarrhea, 25 had raised triglyceride levels (more than 1.9 mmol/L) [79].

People with kidney disease and increased triglycerides may have a poorer prognosis.

7) Pancreas Inflammation (Pancreatitis)

High blood triglyceride may cause chronic pancreatitis, whereas extremely high levels (above 1,000 mg/dL) can lead to acute pancreatitis  [80, 81, 82, 83, 84, 85].

In 582 patients with acute pancreatitis, blood triglyceride levels more than 2.26 mmol/L increased the risk of [86]:

  • Mental disturbances
  • Infection of dead pancreatic tissue (pancreatic necrosis)
  • Acute respiratory distress syndrome (RDS)
  • Systemic inflammatory response syndrome (SIRS)
  • Acute kidney injury

High blood triglycerides also increased hospital stay, intensive care unit (ICU) admissions, and ICU stay duration [86].

High triglyceride levels increase the risk of pancreas inflammation and health complications that can result from it.

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Takeaway

Triglycerides are fats that you absorb from food or create in the liver from other compounds. If your levels get too high, you will be at an increased risk of many chronic health problems, including heart disease and diabetes.

Built-up triglycerides can damage and clog blood vessels, reduce fat burning in cells, and increase fat storage in the liver. High levels are often accompanied by an increase in LDL cholesterol and a drop in HDL cholesterol, a detrimental combination for your heart and overall health.

Your diet and weight have a huge impact on your levels. High-carbohydrate, low-fat diets and obesity increase triglycerides. Vitamin D deficiency, smoking, an underactive thyroid, inflammation, genetics, and certain medications and diseases can also raise your levels.

About the Author

Ana Aleksic - MS (PHARMACY) - Writer at Selfhacked

Ana Aleksic, MSc (Pharmacy)

MS (Pharmacy)

Ana received her MS in Pharmacy from the University of Belgrade.

Ana has many years of experience in clinical research and health advising. She loves communicating science and empowering people to achieve their optimal health. Ana spent years working with patients who suffer from various mental health issues and chronic health problems. She is a strong advocate of integrating scientific knowledge and holistic medicine.

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